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  • Question 1 - Which one of these infectious diseases typically has an incubation period of between...

    Correct

    • Which one of these infectious diseases typically has an incubation period of between 1 and 3 weeks?

      Your Answer: Chickenpox

      Explanation:

      The incubation period for Chickenpox is 7-23 days (usually around 2 weeks).

      Incubation period of botulism is 18-36 hours

      Incubation period of Meningococcaemia is 1-7 days.

      Incubation period of Gonorrhoea is 3-5 days.

      Incubation period of Hepatitis A is 3-5 weeks.
      Other infectious with an incubation period of between 1 and 3 weeks are:
      Whooping cough (7-10 days)
      Brucellosis (7-21 days)
      Leptospirosis (7-12 days)
      Malaria (7-40 days depending on strain)
      Typhoid (8-21 days)
      Measles (10-18 days)
      Mumps (14-18 days)
      Rubella (14-21 days)

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      13.7
      Seconds
  • Question 2 - A 73-year-old woman arrives at the emergency department 48 hours after being discharged from...

    Correct

    • A 73-year-old woman arrives at the emergency department 48 hours after being discharged from the hospital after a two-week stay for sepsis treatment. She has fever, productive cough with thick green sputum, and shortness of breath. An X-ray shows left lower lobe pneumonia. Which of the bacteria listed below is more likely to be the causative agent:

      Your Answer: Pseudomonas aeruginosa

      Explanation:

      Hospital-acquired pneumonia (HAP), or nosocomial pneumonia, is a lower respiratory infection that was not incubating at the time of hospital admission and that presents clinically 2 or more days after hospitalization. Pneumonia that presents sooner should be regarded as community­ acquired pneumonia. VAP refers to nosocomial pneumonia that develops among patients on ventilators. Ventilator-associated pneumonia (VAP) is defined as pneumonia that presents more than 48 hours after endotracheal intubation.

      Common bacteria involved in hospital-acquired pneumonia (HAP) include the following [10] :
      Pseudomonas Aeruginosa
      Staphylococcus aureus, including methicillin-susceptible S aureus (MSSA) and methicillin-resistant S aureus (MRSA)
      Klebsiella pneumoniae
      Escherichia coli

    • This question is part of the following fields:

      • Infections
      • Microbiology
      58.3
      Seconds
  • Question 3 - Regarding antacids, which of the following statements is CORRECT: ...

    Correct

    • Regarding antacids, which of the following statements is CORRECT:

      Your Answer: Antacids are contraindicated in hypophosphataemia.

      Explanation:

      Antacids are contraindicated in hypophosphataemia. Liquid preparations are more effective than tablet preparations. Magnesium-containing antacids tend to be laxative whereas aluminium-containing antacids tend to be constipating. Antacids are best taken when symptoms occur or are expected, usually between meals and at bedtime. Antacids should preferably not be taken at the same time as other drugs since they may impair absorption.

    • This question is part of the following fields:

      • Gastrointestinal
      • Pharmacology
      33.4
      Seconds
  • Question 4 - A 23-year-old male is referred to your haematology clinic after an acute attack...

    Correct

    • A 23-year-old male is referred to your haematology clinic after an acute attack of haemolytic anaemia. He was diagnosed with glucose-6-phosphate dehydrogenase deficiency ten years ago.

      Which ONE of the following options is FALSE with regards to this disorder?

      Your Answer: Acute haemolysis can be triggered by cephalosporin antibiotics

      Explanation:

      Glucose-6-phosphate dehydrogenase deficiency is an X-linked recessive disorder in which there is a deficiency of the enzyme G6PD. This causes instability of red blood cell membranes under oxidative stress leading to haemolysis.

      Triggers include:
      1) Fava beans
      2) Sulphonamides
      3) Primaquine
      4) Anti-TB drugs
      5) Infections

      Most individuals will be asymptomatic until exposed to one of the triggers listed above. It is the commonest human enzyme defect and affects males more than females because of the X-linked inheritance pattern. The use of penicillins and cephalosporins is generally safe.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      19
      Seconds
  • Question 5 - Which of the following nerves supplies the abductor pollicis brevis? ...

    Correct

    • Which of the following nerves supplies the abductor pollicis brevis?

      Your Answer: The recurrent branch of the median nerve

      Explanation:

      Abductor pollicis brevis is innervated by the recurrent (thenar) branch of median nerve (root value C8 and T1).

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      10.1
      Seconds
  • Question 6 - Beta cells of the endocrine pancreas produce which of the following hormones: ...

    Correct

    • Beta cells of the endocrine pancreas produce which of the following hormones:

      Your Answer: Insulin

      Explanation:

      Insulin is produced by beta cells, located centrally within the islets of Langerhans, in the endocrine tissues of the pancreas. Insulin is a polypeptide hormone consisting of two short chains (A and B) linked by disulphide bonds. Proinsulin is synthesised as a single-chain peptide. Within storage granules, a connecting peptide (C peptide) is removed by proteases to yield insulin. Insulin release is stimulated initially during eating by the parasympathetic nervous system and gut hormones such as secretin, but most output is driven by the rise in plasma glucose concentration that occurs after a meal. The effects of insulin are mediated by the receptor tyrosine kinase.

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      4.7
      Seconds
  • Question 7 - Regarding the factor V Leiden gene mutation, which of the following best describes...

    Correct

    • Regarding the factor V Leiden gene mutation, which of the following best describes the clinical effect:

      Your Answer: It results in increased levels of activated factor V.

      Explanation:

      Factor V Leiden gene mutation is the most common inherited cause of an increased risk of venous thrombosis. Activated protein C normally breaks down activated factor V and so should slow the clotting reaction and prolong the APTT, but a mutation in the factor V gene makes factor V less susceptible to cleavage by activated protein C, resulting in increased levels of activated factor V.Heterozygotes for factor V Leiden are at an approximately five- to eight- fold increased risk of venous thrombosis compared to the general population (but only 10% of carriers will develop thrombosis in their lifetime). Homozygotes have a 30 – 140-fold increased risk. The incidence of factor V Leiden in patients with venous thrombosis is approximately 20 – 40%. It does not increase the risk of arterial thrombosis.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      66.9
      Seconds
  • Question 8 - A 60-year-old patient with a history of hypertension and chronic kidney disease (CKD) walks...

    Correct

    • A 60-year-old patient with a history of hypertension and chronic kidney disease (CKD) walks into the clinic to discuss her most recent blood results indicating an accelerated progression of CKD.

      Which of the following is the correct definition for accelerated progression of CKD?

      Your Answer: A sustained decrease in GFR of 15 ml/minute/1.73 m 2 per year

      Explanation:

      Chronic kidney disease (CKD) is a disorder in which kidney function gradually deteriorates over time. It’s fairly prevalent, and it typically remains unnoticed for years, with only advanced stages of the disease being recognized. There is evidence that medication can slow or stop the progression of CKD, as well as lessen or prevent consequences and the risk of cardiovascular disease (CVD).

      CKD is defined as kidney damage (albuminuria) and/or impaired renal function (GFR 60 ml/minute per 1.73 m2) for three months or longer, regardless of clinical diagnosis.

      A prolonged decline in GFR of 25% or more with a change in GFR category within 12 months, or a sustained drop in GFR of 15 ml/minute/1.73 m² per year, is considered accelerated CKD progression.
      End-stage renal disease (ESRD) is defined as severe irreversible kidney impairment with a GFR of less than 15 ml/minute per 1.73 m² and a GFR of less than 15 ml/minute per 1.73 m².

    • This question is part of the following fields:

      • Physiology
      • Renal Physiology
      14.4
      Seconds
  • Question 9 - Which of the following decreases activation of vitamin D: ...

    Correct

    • Which of the following decreases activation of vitamin D:

      Your Answer: Chronic renal failure

      Explanation:

      Calcium deficiency (low Ca2+ diet or hypocalcemia) activates 1-alpha-hydroxylase in the cells of the renal proximal tubule which catalyses the conversion of vitamin D to its active form, 1,25-dihydroxycholecalciferol. Increased parathyroid hormone (PTH) and hypophosphatemia also stimulate the enzyme. Chronic renal failure is associated with a constellation of bone diseases, including osteomalacia caused by failure of the diseased renal tissue to produce the active form of vitamin D.

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      14.2
      Seconds
  • Question 10 - Which of the following is NOT a function of antibodies: ...

    Correct

    • Which of the following is NOT a function of antibodies:

      Your Answer: Act as antigen receptors on T lymphocytes

      Explanation:

      Antibodies:
      Neutralise toxins and prevent attachment of pathogens
      Target, opsonise or agglutinate (clump together) antigens for phagocytosis
      Activate the complement cascade (leading to lysis or opsonisation of the pathogen)
      Act as antigen receptors on B lymphocytes
      Activate antibody-dependent cell-mediated cytotoxicity by natural killer (NK) cells or T cytotoxic cells
      Provide mucosal immunity (IgA-mediated)
      Stimulate degranulation of mast cells (IgE and IgG mediated)
      Provide passive immunity to the newborn (through transplacental passage of IgG and secretion of IgA in breast milk)

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      12.6
      Seconds
  • Question 11 - A 12-year-old boy presents to the ED with symptoms suggesting an anaphylactic reaction.

    Which...

    Correct

    • A 12-year-old boy presents to the ED with symptoms suggesting an anaphylactic reaction.

      Which of these statements about anaphylaxis is true?

      Your Answer: The immunoglobulin-antigen complex binds to Fc receptors on the surface of mast cells.

      Explanation:

      Anaphylaxis is an example of a type I hypersensitivity reaction.

      It is IgE mediated.

      It requires a prior exposure to the antigen. The initial exposure sensitizes the body to the antigen and a second exposure to that antigen leads to an anaphylactic reaction.

      Massive calcium influx into the cells leads to mast cell degranulation.

      The Immunoglobulin antigen complex binds to Fc receptors on the surface of mast cells. The result is mast cell degranulation and release of histamine, proteoglycans and serum proteases from cytoplasmic granules.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      26.2
      Seconds
  • Question 12 - Which of the following side effects has limited the use of etomidate as...

    Correct

    • Which of the following side effects has limited the use of etomidate as an intravenous induction agent:

      Your Answer: Adrenocortical suppression

      Explanation:

      Etomidate causes the least cardiovascular depression of the intravenous induction agents, with only a small reduction in the cardiac output and blood pressure. In the past, etomidate was widely used to induce anaesthesia in the shocked, elderly or cardiovascularly unstable patient. However, more recently it has become less popular as a single induction dose blocks the normal stress-induced increase in adrenal cortisol production for 4 – 8 hours, and up to 24 hours in elderly and debilitated patients. Although no increase in mortality has been identified following a single dose during induction of anaesthesia, the use of etomidate has declined due to a perceived potential morbidity.

    • This question is part of the following fields:

      • Anaesthesia
      • Pharmacology
      12.2
      Seconds
  • Question 13 - Which of the following nerves innervates the adductor brevis? ...

    Correct

    • Which of the following nerves innervates the adductor brevis?

      Your Answer: Obturator nerve

      Explanation:

      Like the majority of the thigh adductors, adductor brevis is innervated by the obturator nerve. Obturator nerve is derived from the lumbar plexus (anterior branches of spinal nerves L2-L4).

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      8
      Seconds
  • Question 14 - A 32-year-old female is diagnosed case of bipolar disorder and is on medication....

    Correct

    • A 32-year-old female is diagnosed case of bipolar disorder and is on medication. She presents to her psychiatric team with symptoms of severe depression. She is currently taking Lithium.

      Out of the following, which is TRUE regarding lithium?

      Your Answer: It commonly causes a tremor

      Explanation:

      Lithium is the drug of choice for bipolar disorders but is commonly associated with side effects and toxicity.

      Fine hand tremor is very commonly seen and reported in as many as 50% of patients during the first week of therapy with Lithium. The tremor tends to reduce with time and is only present in around 5% of patients taking the medication two years or longer. Lithium tremors are more common with older age, presumably due to the additive effects of age-related essential tremors.

      Option The normal therapeutic range is 2.0-2.5 mmol/l: Lithium should be carefully monitored as it has a very low therapeutic index. The normal therapeutic range is 0.4-0.8 mmol/l. Levels should be checked one week after starting therapy and one week after every change in dosage. (Option Levels should be checked one month after starting therapy)

      Option It can induce hyperthyroidism: Lithium has a known effect on thyroid function. Lithium decreases the production of T4 and T3 and commonly causes hypothyroidism. More rarely, lithium causes hyperthyroidism due to thyroiditis.

      Option It can induce diabetes mellitus: Lithium can induce nephrogenic diabetes insipidus but not diabetes mellitus.

    • This question is part of the following fields:

      • CNS Pharmacology
      • Pharmacology
      99.9
      Seconds
  • Question 15 - Regarding T helper cells, which of the following statements is CORRECT: ...

    Correct

    • Regarding T helper cells, which of the following statements is CORRECT:

      Your Answer: They form the vast majority (about 75%) of the total circulating T-cell population.

      Explanation:

      CD4+ T-cells (Helper T cells)Recognise antigen only in association with HLA class II molecules (found on antigen presenting cells (APCs) e.g. dendritic cells, B-cells; present exogenous antigens that have been phagocytosed/endocytosed into intracellular vesicles)Form most of the circulating T-cell population (about 75%)Secrete cytokines (e.g. IFN-gamma) which are required for recruitment and activation of other immune cells such as macrophages, T cytotoxic cells and NK cells and for the activation of and production of immunoglobulin from B-cells

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      64.9
      Seconds
  • Question 16 - What type of pump is the Na+/K+ATPase pump? ...

    Incorrect

    • What type of pump is the Na+/K+ATPase pump?

      Your Answer: A symporter

      Correct Answer: An antiporter

      Explanation:

      In order for primary active transport to pump ions against their electrochemical gradient, chemical energy is used in the form of ATP. This is facilitated by the Na+/K+-ATPase antiporter pump, which uses metabolic energy to move 3 Na+ions out of the cell for every 2 K+ions that come in, against their respective electrochemical gradients. As a result, the cell the maintains a high intracellular concentration of K+ions and a low concentration of Na+ions.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      11.8
      Seconds
  • Question 17 - A 1-year-old male is brought to the paediatrician by his mother due to...

    Correct

    • A 1-year-old male is brought to the paediatrician by his mother due to swelling of the right knee after a minor fall. On examination, the right knee is swollen, fluctuant and tender. Ultrasound-guided aspiration reveals a massive hemarthrosis. Family history shows that his older brother also has a bleeding disorder.

      Which one of the following conditions does the patient most likely have?

      Your Answer: Haemophilia A

      Explanation:

      A diagnosis of Haemophilia is supported in this patient by the family history and the presence of hemarthrosis-both characteristics of Haemophilia. Haemophilia A is caused by Factor VIII deficiency, leading to impaired coagulation. This disease typically presents after six months when the child starts crawling.

      Von Willebrand disease presents with nosebleeds and hematomas. Idiopathic thrombocytopenic purpura presents with bruises that resemble a rash.

      Glucose-6-phosphate dehydrogenase (G6PD) deficiency presents with haemolytic anaemia induced by specific drugs or foods.

      Factor V Leiden mutation causes blood clotting rather than bleeding.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      43.2
      Seconds
  • Question 18 - You've been summoned to a young man in the resus area who has...

    Correct

    • You've been summoned to a young man in the resus area who has an SVT. You decide to use adenosine after trying several vagal manoeuvres without success.

      The use of adenosine is not contraindicated in which of the following situations?

      Your Answer: Concurrent use of a beta-blocker

      Explanation:

      The use of a beta-blocker at the same time increases the risk of myocardial depression, but it is not a contraindication.
      The use of adenosine is contraindicated in the following situations:
      Asthma
      COPD (chronic obstructive pulmonary disease)
      Decompensated heart failure 
      Long QT syndrome
      AV block in the second or third degree
      Sinusitis is a condition in which the sinuses become (unless pacemaker fitted)
      Hypotension that is severe

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      11.8
      Seconds
  • Question 19 - You suspected typhoid disease in a patient who had recently returned from South...

    Correct

    • You suspected typhoid disease in a patient who had recently returned from South America and presented to the emergency department with fever, constipation, and a rose spot rash. Which of the following antibiotics will be administered to this patient?

      Your Answer: Cefotaxime

      Explanation:

      Typhoid fever, often known as enteric fever, is a potentially fatal multi-systemic sickness caused predominantly by Salmonella enterica serotype typhi and, to a lesser extent, paratyphi A, B, and C.

      Cefotaxime is the first-line treatment for typhoid fever (or ceftriaxone). In cases of mild or moderate sickness caused by multiresistant pathogens, azithromycin is an option. If the bacterium is sensitive, ciprofloxacin is an option.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      10
      Seconds
  • Question 20 - All of the following statements are considered true regarding likelihood ratios, except: ...

    Correct

    • All of the following statements are considered true regarding likelihood ratios, except:

      Your Answer: If less than one, indicates that the information increases the likelihood of the suspected diagnosis

      Explanation:

      The Likelihood Ratio (LR) is the likelihood that a given test result would be expected in a patient with the target disorder compared to the likelihood that that same result would be expected in a patient without the target disorder.

      The LR is used to assess how good a diagnostic test is and to help in selecting an appropriate diagnostic tests or sequence of tests. They have advantages over sensitivity and specificity because they are less likely to change with the prevalence of the disorder, they can be calculated for several levels of the symptom/sign or test, they can be used to combine the results of multiple diagnostic test and they can be used to calculate post-test probability for a target disorder.

      A LR greater than 1 produces a post-test probability which is higher than the pre-test probability. An LR less than 1 produces a post-test probability which is lower than the pre-test probability. When the pre-test probability lies between 30 and 70 per cent, test results with a very high LR (say, above 10) rule in disease. An LR below 1 produces a post-test probability les than the pre-test probability. A very low LR (say, below 0.1) virtually rules out the chance that the patient has the disease.

    • This question is part of the following fields:

      • Evidence Based Medicine
      5.4
      Seconds
  • Question 21 - Which of the following statements is false regarding the biceps brachii muscle? ...

    Correct

    • Which of the following statements is false regarding the biceps brachii muscle?

      Your Answer: It pronates the radioulnar joint in the forearm

      Explanation:

      The biceps brachii muscle is one of the chief muscles of the arm. The origin at the scapula and the insertion into the radius of the biceps brachii means it can act on both the shoulder joint and the elbow joint, which is why this muscle participates in a few movements of the arm. It derives its name from its two heads which merge in one unique distal body, defining the unusual structure of the muscle.

      The biceps brachii muscle is supplied by the musculocutaneous nerve (C5-C6), a branch of the brachial plexus.

      Arterial supply to the biceps brachii muscle varies considerably, coming from up to eight vessels originating from the brachial artery in the middle third of the arm.

      In the shoulder joint both muscle heads partially enforce opposite movements. The long head pulls the arm away from the trunk (abduction) and turns it inwards (inward rotation) whereas the short head pulls the arm back towards the trunk (adduction). When both heads contract simultaneously it leads to an arm bend (flexion). In the elbow joint the muscle bends the forearm (flexion) and rotates it outwards (supination). The supination is most powerful in a flexed elbow. In addition to the movement functions, the biceps has the important task to support the humeral head within the shoulder joint. Its antagonist is the triceps brachii in the posterior compartment of the arm.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      12.9
      Seconds
  • Question 22 - At rest, skeletal muscle accounts for between 15-20% of cardiac output and accounts...

    Correct

    • At rest, skeletal muscle accounts for between 15-20% of cardiac output and accounts for around 50% of body weight. This can increase to nearly 80% of cardiac output during exercise. Skeletal muscle circulation is highly controlled and has a number of specialized adaptations as a result of this high degree of disparity during exercise, in combination with the diversity in the size of skeletal muscle around the body.

      What is the primary mechanism for boosting skeletal muscle blood flow during exercise?

      Your Answer: Metabolic hyperaemia

      Explanation:

      In skeletal muscle, blood flow is closely related to metabolic rate. Due to the contraction of precapillary sphincters, most capillaries are blocked off from the rest of the circulation at rest and are not perfused. This causes an increase in vascular tone and vessel constriction. As metabolic activity rises, this develops redundancy in the system, allowing it to cope with greater demand. During exercise, metabolic hyperaemia, which is induced by the release of K+, CO2, and adenosine, recruits capillaries. Sympathetic vasoconstriction in the active muscles is overridden by this. Simultaneously, blood flow in non-working muscles is restricted, preserving cardiac output. During exercise, muscle contractions pump blood through the venous system, raising the pressure differential between arterioles and venules and boosting blood flow via capillaries.

      Capillary angiogenesis is evident when muscles are used repeatedly (e.g. endurance training). It is a long-term effect, not a quick fix for increased blood flow.

      The local partial pressure of alveolar oxygen is the primary intrinsic control of pulmonary blood flow (pAO2). Low pAO2 promotes arteriole vasoconstriction and vice versa. The hypoxic pulmonary vasoconstriction (HPV) reflex allows blood flow to be diverted away from poorly ventilated alveoli and towards well-ventilated alveoli in order to maximize gaseous exchange.

    • This question is part of the following fields:

      • Cardiovascular Physiology
      • Physiology
      3.5
      Seconds
  • Question 23 - An 18-year-old student presents with a 1-week history of sore throat, low grade...

    Correct

    • An 18-year-old student presents with a 1-week history of sore throat, low grade fever, and malaise. Upon history taking, she noted that she had a fine rash over her body a week ago that quickly fades. Further examination and observation was done and the presence of mild splenomegaly was noted. Her test shows positive for heterophile antibody test, suspecting a diagnosis of infectious mononucleosis.

      Which of the following characteristics is mostly associated with the diagnosis of infectious mononucleosis?

      Your Answer: Atypical lymphocytes

      Explanation:

      Epstein-Barr virus causes infectious mononucleosis which is a clinical entity characterized by sore throat, cervical lymph node enlargement, fatigue and fever.

      It is accompanied by atypical large peripheral blood lymphocytes. These atypical lymphocytes, also known as Downey cells, are actually activated CD8 T lymphocytes, most of which are responding to EBV-infected cells.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      13.7
      Seconds
  • Question 24 - A 16-year old boy is brought to the emergency room after suffering a...

    Correct

    • A 16-year old boy is brought to the emergency room after suffering a traffic accident. Upon examination, there is noted ipsilateral loss of proprioception and vibration, ipsilateral motor loss, and contralateral loss of pain and temperature sensation. A spinal cord injury is given as a diagnosis.

      Which of the following is the most probable cause of this manifestation?

      Your Answer: Brown-Séquard syndrome

      Explanation:

      Brown-Sequard Hemicord Syndrome consists of ipsilateral weakness (corticospinal tract) and loss of joint position and vibratory sense (posterior column), with contralateral loss of pain and temperature sense (spinothalamic tract) one or two levels below the lesion. Segmental signs, such as radicular pain, muscle atrophy, or loss of a deep tendon reflex, are unilateral. Partial forms are more common than the fully developed syndrome.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      10.7
      Seconds
  • Question 25 - Which of the following drugs used in the management of hyperkalaemia does not...

    Correct

    • Which of the following drugs used in the management of hyperkalaemia does not affect serum potassium levels:

      Your Answer: Calcium gluconate

      Explanation:

      Calcium gluconate is given to antagonise cardiac cell membrane excitability to reduce the risk of arrhythmias. It has no effect on serum potassium levels unlike the alternative drugs listed above.

    • This question is part of the following fields:

      • Fluids And Electrolytes
      • Pharmacology
      6.3
      Seconds
  • Question 26 - You're called to a cardiac arrest in your Emergency Department resuscitation area. The...

    Correct

    • You're called to a cardiac arrest in your Emergency Department resuscitation area. The rhythm strip is shown in the diagram below. Defibrillation has already been attempted three times on the patient. You intended to administer amiodarone, but your department has informed you that it is not available. In these circumstances, if amiodarone is not available, which of the following drugs is recommended by the ALS guidelines? Ventricular fibrillation

      Your Answer: Lidocaine

      Explanation:

      If amiodarone is unavailable in VF/pVT arrests, lidocaine at a dose of 1 mg/kg can be used instead, according to the latest ALS guidelines. If amiodarone has already been given, no lidocaine should be given.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      2.4
      Seconds
  • Question 27 - A patient is complaining of painless jaundice. His bilirubin levels are abnormally high.

    Which...

    Correct

    • A patient is complaining of painless jaundice. His bilirubin levels are abnormally high.

      Which of the following statements about bile is correct?

      Your Answer: Bile acids are amphipathic

      Explanation:

      The liver produces bile on a constant basis, which is then stored and concentrated in the gallbladder. In a 24-hour period, around 400 to 800 mL of bile is generated.

      Bile is involved in the following processes:
      Fats are broken down into fatty acids.
      Waste products are eliminated.
      Cholesterol homeostasis is the balance of cholesterol in the body.

      The enteric hormones cholecystokinin and secretin are primarily responsible for bile secretion. When chyme from an unprocessed meal enters the small intestine, they are released, and they play the following function in bile secretion and flow:

      Cholecystokinin promotes gallbladder and common bile duct contractions, allowing bile to reach the intestine.
      Secretin enhances the secretion of bicarbonate and water by biliary duct cells, increasing the amount of bile and its flow into the gut.

      Bile acids have a hydrophobic and hydrophilic area, making them amphipathic. Bile acids’ amphipathic nature allows them to perform the following crucial functions:

      Emulsification of lipid aggregates increases the surface area of fat and makes it easier for lipases to digest it.
      Lipid solubilization and transport: solubilizes lipids by creating micelles, which are lipid clumps that float in water.

    • This question is part of the following fields:

      • Gastrointestinal Physiology
      • Physiology
      7.5
      Seconds
  • Question 28 - A 23-year-old female has been prescribed a medication in the first trimester of...

    Correct

    • A 23-year-old female has been prescribed a medication in the first trimester of pregnancy due to a life-threatening medical problem. After delivery, the foetus is found to have nasal hypoplasia, stippling of his bones and atrophy of bilateral optic discs along with growth retardation.

      Which ONE of the following drugs has this woman most likely received?

      Your Answer: Warfarin

      Explanation:

      Warfarin is teratogenic and can cause a host of abnormalities in the growing foetus. These include hypoplasia of the nasal bridge, stippling of the epiphyses, multiple ophthalmic complications, growth retardation, pectus carinatum, atrial septal defect, ventriculomegaly and a patent ductus arteriosus.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      5.4
      Seconds
  • Question 29 - A 68-year-old man with multiple myeloma presents with complaints of abdominal pain and...

    Correct

    • A 68-year-old man with multiple myeloma presents with complaints of abdominal pain and malaise. A series of blood tests is done and his calcium level is 2.96 mmol/l.

      What effect will this blood test result have on gastric secretions?

      Your Answer: Stimulate the release of gastrin

      Explanation:

      Hypercalcaemia stimulates the release of gastrin from the G-cells in the pyloric antrum of the stomach, the duodenum and the pancreas.

      Gastrin is also released in response to:
      Stomach distension
      Vagal stimulation
      The presence of amino acids.

      Gastrin release is inhibited by the presence of acid and somatostatin.

    • This question is part of the following fields:

      • Gastrointestinal Physiology
      • Physiology
      12.3
      Seconds
  • Question 30 - A patient with a history of worsening chronic breathlessness on exertion undergoes lung...

    Correct

    • A patient with a history of worsening chronic breathlessness on exertion undergoes lung function testing. The results demonstrate an FEV 1 that is 58% predicted and an FEV 1 /FVC ratio less than 0.7.
      Which of the following is the most likely diagnosis? Select ONE answer only.

      Your Answer: COPD

      Explanation:

      Obstructive lung disorders are characterised by airway obstruction. Many obstructive diseases of the lung result from narrowing of the smaller bronchi and larger bronchioles, often because of excessive contraction of the smooth muscle itself.
      In obstructive lung disease, FEV1is reduced to <80% of normal and FVC is usually reduced but to a lesser extent than FEV1. The FEV1/FVC ratio is reduced to <0.7.
      Types of obstructive lung disorders include:
      Chronic obstructive pulmonary disease (COPD)
      Asthma
      Bronchiectasis

    • This question is part of the following fields:

      • Physiology
      • Respiratory Physiology
      6.1
      Seconds

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